本文關(guān)鍵詞： 二甲雙胍 血糖控制 型糖尿病 羅格列酮 生活方式 胰島素治療 青少年 青春期 干預(yù) 兒童　出處：《中國(guó)全科醫(yī)學(xué)》2012年26期 　論文類型：期刊論文

【摘要】：背景盡管青春期2型糖尿病患病率有所上升,但用于指導(dǎo)治療的現(xiàn)有資料很少,我們對(duì)比了3種療法對(duì)兒童和青少年新發(fā)2型糖尿病患者血糖控制的效果。方法本研究入選患者需符合以下條件:10～17歲、用二甲雙胍(1 000 mg,2次/d)治療、糖化血紅蛋白(HbA1c)8%;將患者隨機(jī)分配到單用二甲雙胍治療組、二甲雙胍+羅格列酮(4 mg,2次/d)組、二甲雙胍+生活方式干預(yù)(通過飲食和運(yùn)動(dòng)減輕體質(zhì)量)組。主要結(jié)果為血糖控制失敗,即HbA1c水平不低于8%并持續(xù)6個(gè)月,或持續(xù)代謝失代償需用胰島素治療。結(jié)果對(duì)入選的699例患者(2型糖尿病的平均病程為7.8個(gè)月)平均隨訪3.86年,發(fā)現(xiàn)有319例(45.6%)患者血糖失控。單用二甲雙胍治療組、二甲雙胍+羅格列酮組、二甲雙胍+生活方式干預(yù)組的失控率分別為51.7%(120/232)、38.6%(90/233)和46.6%(109/234)。二甲雙胍+羅格列酮組的療效優(yōu)于單用二甲雙胍(P=0.006);二甲雙胍+生活方式干預(yù)組的療效居中,但與單用二甲雙胍治療組和二甲雙胍+羅格列酮組比較,療效無明顯差異。按照性別和種族進(jìn)一步分析顯示,三種療法的長(zhǎng)期療效有差異,非西班牙裔黑人參試者單用二甲雙胍治療的效果最差,女性參試者用二甲雙胍+羅格列酮效果最好。有19.2%的參試者發(fā)生了嚴(yán)重不良事件。結(jié)論近半數(shù)的2型糖尿病兒童和青少年,其血糖控制與二甲雙胍單藥療法相關(guān)。在不強(qiáng)調(diào)生活干預(yù)的情況下,加用羅格列酮治療的效果優(yōu)于單用二甲雙胍治療。
[Abstract]:Background although the prevalence of type 2 diabetes in adolescence has increased, there is little information available to guide treatment. We compared the effects of three treatments on blood glucose control in children and adolescents with newly diagnosed type 2 diabetes. Treated with metformin 1 000 mg / d, glycosylated hemoglobin (HbA1) 8; Patients were randomly assigned to the metformin treatment group and the metformin rosiglitazone 4 mg / d group. Metformin lifestyle intervention (reducing body mass through diet and exercise). The main result was a failure of blood glucose control, i.e., HbA1c level was no less than 8% and lasted for 6 months. Results the mean course of disease of 699 patients with type 2 diabetes mellitus was 7.8 months and the mean follow-up was 3.86 years. A total of 319 patients (45.6%) were found to have lost control of their blood glucose. The patients were treated with metformin alone and in the metformin rosiglitazone group. The rate of loss of control in the metformin lifestyle intervention group was 51.7 / 232). The curative effect of metformin rosiglitazone group was better than that of metformin rosiglitazone group alone. The therapeutic effect of metformin lifestyle intervention group was middle, but there was no significant difference between the treatment group and the group treated with metformin rosiglitazone, according to the gender and race further analysis showed that the therapeutic effect of metformin lifestyle intervention group was higher than that of metformin treatment group and metformin rosiglitazone group. There were differences in long-term outcomes among the three treatments, with non-Hispanic black participants having the worst effect on metformin alone. Metformin rosiglitazone was the most effective for female participants. 19.2% of the participants had severe adverse events. Conclusion nearly half of the children and adolescents with type 2 diabetes were treated with metformin rosiglitazone. The effect of rosiglitazone plus rosiglitazone was better than that of metformin alone.
【作者單位】： 中國(guó)石油中心醫(yī)院;
【分類號(hào)】：R587.1
【正文快照】： 原文見:TODAY Study Group.A Clinical Trial to Maintain Glycemic Control in Youth with Type 2 Diabetes[J].N EnglJ Med,2012,366:2247-2256.published at http://www.nejm.org/doi/full/10.1056/NEJMoa1109333WONCA研究論文摘要匯編——青春期2型糖尿病血糖控制臨床試驗(yàn)

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 楊東明;;中效胰島素聯(lián)合二甲雙胍治療老年2型糖尿病22例療效分析[J];實(shí)用糖尿病雜志;2008年02期

2 劉芳;劉滿;;二甲雙胍和格列齊特治療2型糖尿病臨床觀察[J];河北醫(yī)藥;2008年04期

3 Katherine Marple;孫磊;;二甲雙胍?guī)椭抑委?型糖尿病[J];糖尿病新世界;2011年09期

4 馬曉偉;;新診斷2型糖尿病及口服降糖藥選擇[J];實(shí)用糖尿病雜志;2007年04期

5 洪天配;田R，

本文編號(hào)：1468275